Stay on target

Researchers have split type 2 diabetes into five sub-diseases, in an effort to help tailor and target early treatment for patients.

This marks the first step toward precision medicine for the metabolic disorder, according to a study published in The Lancet Diabetes & Endocrinology journal.

Most diagnosed cases of diabetes (75 percent to 85 percent) are type 2, typically occurring later in life (hence its “adult-onset” title)—when the body stops producing enough insulin to meet the increased demands of weight gain.

But while scientists are aware that the condition is highly variable, little has been done to adapt medical care for individuals.

“Evidence suggests that early treatment for diabetes is crucial to prevent life-shortening complications,” lead study author Leif Groop, a researcher at the Lund University Diabetes Center in Sweden, said in a statement. “More accurately diagnosing diabetes could give us valuable insights into how it will develop over time, allowing us to predict and treat complications before they develop.”

An examination of 14,775 Scandinavian patients recently diagnosed with adult-onset diabetes revealed five different disease profiles: three severe and two mild.

Among the more serious cases are a group with acute insulin resistance and a significantly higher risk of kidney disease (11 to 17 percent of patients), a set of “relatively young” insulin-deficient individuals with poor metabolic control but no auto-antibodies (9 to 20 percent), and insulin-deficient patients with auto-antibodies associated with autoimmune diabetes (6 to 15 percent).

Thankfully, the disease presents itself most commonly (39 to 47 percent) as a moderate form, often seen in elderly folks; the other mild category affects 18 to 23 percent of patients, and is mainly seen in obese people.

Each of these subsets of diabetes is genetically distinct, according to the study, so it’s unlikely these are simply different stages of the same disease. Which is good news for many sufferers not receiving appropriate treatment.

Don’t expect a personalized prescription plan just yet, though.

Additional research is required: The authors are still unsure whether the five types of adult-onset diabetes have different causes, or whether they change over time as patients age.